AF - 43215City of Fridley, Minn.
, ,�,
BUILDING FERMIT N° 5 s 8 3 :� -
Date: _.._�W � �� �� .._.. .._.._...__.._.._..,,....___._ _
._. _._ _._
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Owner: _... .. . . .._.._�!!�e� .�.�..�w�..w_._.__......._.. Builder .. _ ��� .. ...�
Address_..___.._._......._..:___.._._..._.__..._..._.........._...._.__...._..._.._.____..__._ Address ._..---..._..___.__.w._....._.__._.�._.._.___._ '
LOC ON OF BUILDING
No. ._ .. Street :
......I�. . . :�j..._.---.___..._._.____..._._ Part Lot _._,......_....R._.._..�...__._
Lot . ..... :'�llock _....� ._..___.._.._.._._ Additian or Sub-Divfsiozl
���r,/R'� / � • �
Corner Lot _.__..._......_....._ Inside Lot .....__ �_.._._ Setback _._71rrGir?'.___.._ Sideyard .� .. ..Z...__�
Sewer Elevatian _.___..._..�_.________._�_.._..._._....__..�.._....... Foundation IIevation ....._......._.._ ` �
.DESCRtPTION OF BUILDiNG
�e v8 �S:
i .. .__ Fr�a►t ��� Depth �...� Height .� S�l. F'L .�Cu. F.t. ���� ,
..._..__.__._.....__.._._._._............ F'ra�►t .._._.._......._.. Depth Height __ Sq. Ft. _�._._..._ E:�t. P't�, �....._.�
Type of Construction .��._._�.�..�__ Es� C'a��l�!w ..�F !!!+ll�!_�To be Completed .._.:_._____ -
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� � .. � - .� . .. � ��y, y ..
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In consideration of the issuance to me of a pernut to construct the building descrlbed abo�ve I a�t+ve tD da �
the proposed work in accordance with the description above set fcsrth and in complience with afl � ei
ordinances of the dty of Fridley. .
�
In cor►sideration of the payment of a fee of $�_.._._.....__, permit is hereby gcanted W..._.. � .
..._.._.....:..�__.._._.__._....._....___.___ to co�struct the building or addition as described above. This permit isg� f�ee'! upon
the express condition that the �erson to whom it is �ranted and his agex�ts, empIayees and wnrlcmen,- itt aJt w�&
done in, around and upon said building, or any part ihereof, shal� c�nform in all respecta to the o� at
Fridley, 1Viinnesota regarding . location, construction, al�eration, maintenance,. repair and maving ai
�within the dty limits and this permit may be revoked at anY time upo� violation o� the pravb�D�ts �
ordinancea
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...� _ .
, . __ :
NOTICE:
� This p�rmit doa not eevk th� eons�n+etion, imhilation fe� wirinq, pWm6in�. pas 6NNno, t�wa ar wM�r. M s� is Ma
tla 9uiidia� In�p�eloe fer s�puat� pumifs for tMw itan�.
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APPLICATION FOR BUILDTNG PERMIT
CiTY OF FRIDLEY, 1�I1�TESOTA
r
Owner`s Name 8uilde �
Rddress Addres
� LOCATION OF BUI�DING
No. � � Street -�����__oPart of Lot �
J
Lot,_,,,,�� ,,��� �� Block „�L� __ Addition or Subdivision
� �
Corner Lot Snside Lot �/ Setback ��Side-Yard � �
SEVJER ELEVATIOL�T I'OUNDATION ELEVATION
Applicant attach to this �orm Certificate of 3urvey of Zot and
proposec� building location.
DE�C1aIPTION OF BUILDING
To b used ass �
Front-��-�-Depth �• Height
Sq. Ft. C1O� Cu. Ft.
� j� / �
Front_ Depth Height
Sc�. Ft. Cu. Ft.
, J
s' . d✓
Type of Construction ` _______ Estimated Cost .•� '
To be Comgleted
The undersigned hereby makes application for a permit for the work
herein specified, agreeing to do all work in strict accordance with
the City of Fridley Ordinances and ruling o� the Department of Huild-
ings, and hereby declares that all the facts and representations
stated ,in this application are true and correct.
DATE ,�_.-- � � D `� � / SIC�NATURE
,
(Schedule of Fee Costs can be found on the Reverse Sic1e).
� APPr B ' i�g ���E�to�
-�-----.-- ---- - __-�.�-�� -
City of Fridley
AppEicatian for P'lumbing and Gas Fitting Penr�it
Dept. of Bldgs. Phoae SU 4-7470
DESCRIPTION OF WORK %
Number, Kind ax►d Location of Fixtures Location J�l �C�
UN' WATER HTR.
y� � VI I-� 6' N Z� W W ? � ;
m,n <.. S,n z Y x} ZZ 'a� p� U� O � c9 Z
3 V � < 7 �� Z <� � O = O V m<� �U' 4(��j K� O F N GAS ELEC.
� O f 00 ✓1 3 H O LL N LL �
Base �
lst � � �
2nd
3rd
4th
• Fuiure Connection Openiags
* New Fixture, Old Openings
PARTIAL RATE SCHEDULE
Sewer
Cesspool
PLUMBING FIXTURE RATE�: NO. RATE TOTAL
Number Fixtures . . . . .. . . . . . . . . . .. . . . . . � x $1.50 $ - � �
Future Fixture Opening . . . . . . . . . . . . . . . . x 120 $
New Fixture Old Opening . . . . . . . . . . . . . . x 1.00 $
Catch Basin ............................ x 3.25 $
U
Water Heater (Up ta 200,000 BT[A . . . . . .� x 2.OU $ a , �
New Ground Run Old Bidg. . . . . . . . . . . . . x 3.25 $
GA3 FITTING FEES: NO. RATE TOTAL
ist 3 Fixtures . . . . . . . . .�_� x $1.50 $ �' �—�
Additional Fixtures ..... ............... x .50 $
Gas Range to 200,000 BTiT . . . . . . . . . . . . . . x 2.00 $
REPAIRS 8c ALTERATIONS—Refer to Code >
Description ..........................................:.....$
TOTAL FEE $ % °Z � � �
City of Fridley:
i
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the faci
and representations stated in this application are true and correct.
_. � FridleY,
Owner _' ��
Kind af Building --
Used as
To be completed about
�
/✓r�--
��
Estimated Cost, $ � � �
Old—New. Building Permit No. �� �PgImit ��o. �
ROUGH � � �� (Of
FINAL
az SM
By �",C/ U
Business Phone
, / ° /�
19____
sue�ecT PERMI .
City of Fridley ° . 1296 �
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �
t
� � RECEIPT NO.
� i y__���_ COMMUNITY DEVELOPMENT DIV. �� �� `
r � � PROTECTIVE INSPECTION SEC. � �
1 �
�4 ' /"��1 � CITY HALL FRIDLEY � 55432 NUMBER REV. DATE PAGE OF APPROVED BY
"'-'�' �'� 612-560-3450
910-F15 5-28-75 � �
10B ADDRESS
620 - Dover Street N.E„ Fridley, Minnesota.
1 LEGA� LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHEO
oescR. 4, 35, 36 W Riverview Heights SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Ardath Fuehrer, 620 Dover St. N.E. Fridley, Minnesota
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO:
SUSSEL GARAGES 185Q Como St. Paul Minnesota
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USEOF BUILDING
Resi.dence
7 CLASS OF WORK
❑ NEW �l ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WOfiK
Construct Attached Garage 18 x 24 x 8
9 CHANGE QF USE FROM TO
STIPULATIONS
Provide Hard Surface Driveway VI/ARHIN� �
Before dig8+ng catl lacal utilities
TEtEPNONE - ELfCtRIC - G,� ��
REQUIRED gy l„A�y
SEPERAfiE PERMITS REQU�RFD FOR
HEATlNG, PLUMgtNG ANp �����S. ��Rf
,
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Fr�e
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION R 1 432 3,456
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND'CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COM� � $3,196 $1.60
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A P
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STj�}UCTION OR THE PERFORMANCE OP CONSTRUCTION. � $8.00
�l PLAN CHECKFEE TOTALFEE
4!.>C u� � -- $9.60
� SIGNATUREOFCONTRACTOFORAUT RIZEDAGENT 1 ATEI WHEN PRO ERLY ALIDATED THIS IS YOUR PERMIT
S S,�` �� � �
E tir�.J f� ( �e<�-,_.c�
SiGNATUREOF OWNERUF OWNER BUILDERI IDATEI BLDG. iNSP ATE
c .�,.. ° . � `��
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THE SUSSEL COMPANY
1850 Como Avenue
St. Paul, Minnesota 55108
612/645-0331
f�Permit by-��� L�� �--
❑ Legal Description
❑ Lot
❑ Blk
❑ Add'n
O Value � � �
�Type Const.�
Slab: ❑ In�By Sussel
❑ B O A x
� �
WORK ORDER
NAME �-i��� L-� � 1C������--- PHONE #i��' �!;
JOB ADDRESS (I LL�' ��'v �f� �'� � IV • �� ' '
BLDG CODE AREA '�� � �%LC �
/
SALESMAN �-'' T � � �"� � { '' CONTRACT DATE� � � � �IZE % � X �- �r
FOR OFFICE USE ONLY
CONTRACTOR `—"�'x �T JOB #��' '� �^`-
SUSSEL JOB # � ���� CONTRACT # ��� ?'
y wner ppro . .
2-STARTING� PO� NTS ONLY , . �
� p .
S. P. L. L �.: .
S. S. P. L.
R.P. L.
Alley : ' i.
��'f', T'0 /`,�"�S�" House
F. Street :
;�' �P�_D�7�E'i�7)ther ' : ._ .
�quare With,� �'4 ' _
_ ,. �
❑,Rods (� �►� . ���,�,fi. � _
�Mesh �.l� � � — '�
l� � _ __. .� _ , ,
❑ Sod Rem. - By -
5•Bag Mix : _ �' ��'� � ! � .
6-BagMix � � � � � � �/l)`� � �; • ' ,.
amping �� . .
�No TampJ'� ,�g ._� �� ` �_ ' I
E� A. B. U. � ' � �'' - '
,�,,
�
,^�� Grade Point �� �� �� �� ;
� � � � -3"� � - � _ � � . �
� ° � � ��QE%�/l�aF l'�:�/k?� �'aoG' � �" � , e , �
�O.H. Dr. Offset :2 t 'JuSSEL �Q �iP1ocK-C3t►7 ��� "x'a,E�,c' ��cafi�.�L� �'o,i_, , . � , ;
r � �_
� S.D. �ocation 1' � / � (,,)rtitUCs�a ty+.r'a l►�►sic..�t.- — : ; _ �: - --
, � ��e�.rJ�otc.. � ��'�.'�'6 So��o ��.' �• f _ ` ': . � :: �
` �Windows l �I� A� CM Ca� ;� . _ � / __ � � . '� X`� �io4�' wi `_... . _ � . __ :
i � �� ' ,_� ,rv-
. . j' . ; . . . / : � . _ �r. � � .. . .^ � .
�
Existing garage: No (� .'� ��✓�^ , N ; , �...� ' �
❑ Detached ❑ Atfached Yes [] � � � {.� � ,
Size of existing:—x -- ;' �-��-�-�t� '
Existing garage will be: : `'� �='��''�-`�� �-^� �v'��''� . Y
❑ Left as is � � � � � � � � � '
❑ Converted to L.S. - By owner ; � � ,� " � , �` �� y � .. ... � r --
❑ Aemoved By: Owner ❑ � `�� � � ' � � � � ^ _. � '
' , -
Sussel ❑ � . , . �
Junk Must Be Removed By Owner y � ' � � �� � � �� � � `
' � ; ' � x 7 !a1, f: ' ,
, ,
,
, � .._
. �, _
. ; ,, -
� � _.�_ : � L,J _,_,._. _ _ ,
�-Specif �, erPSovals by Sus- � �% ' � � /�, �� �''� r� •S � �
_1
Sel r^CSwner rees, bushes, etc. �' ,
� � i �
❑ Show approx. dist. garage to �'
; �: �
house and all prop. lines , ° • ' • ' ° ; ' , ' . `
,
Stakes visible - ❑ Yes O No . ' ' ' ; _: _ .
. ,.
Survey available - � Yes ❑ No �� �� � � � �� ._ �, ;_ ; ._ �_ , �
❑ Special instructions from s �8 � , -_ _ , -� ' ' '
owner: � � ° � � � --
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:
,
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PART OF' CON7RACT #' L _ ' . DiR�q7lC3r�
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,._-'7^.yq^..;n;..:.;,,':-': � �
SUSSEL GARAGES SUSSEL�COMPANY
:�u� . � �:Lv�:�� ��� Ga�L�
„'iV:�' U�I��.,:I.lid'..1:��N `—
.,;�;:i� GV��:,lfAi'vu �_` —
�� IY�.�'�! ..) i.�l'1� .J L':�J i�Y �J I�L�1`:I.TLL�J
:� z z ��, _ I 8�C ���----
iv��i:;� ;�4T�4 —�sZE1�.Q�¢-
t�DD:.�a.� _.�?d ���.�i• v•.�
,, : �t�.�.Q�_
: �tL��
2x6 wall ties 32" C.C.
All ti�s "6�d" uraced to rafters
2x4 9� collc:�� i,ies
�r1ALZ S?i�.ATHII�dG : �.� �� ��,e��LITC
S I D I NG : � u�"id•�l?�AR� --
OVERH�'AD t�00:� rI�AD�:� :
:�ouble 2x12 �,vith
,s�t steel ply�rvooci
f'iller.
9x y2 " Pa�QEO �Qos?
�TGS, '
9"
1ix7 Anchor Bolt
p�r �'.13.C.
Grade Line
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9 f1 f'" /1 ��1 n`�r� n��� r. �� i r� � � �. i r� ,.�� . w i n i � r.. .-� -r , r r.r n n r� � 1/� n 1 r f/'` 9 n\ �` �1 r�i'7 rl �
} , ( ___.. _ .
•', ' � ' L'>I_(}L;� L`,! 1<1\/1.�� 'dICVI Fi"t1(�W�`�"
. ` _
• �NDUSTRIAL ' � • � • � .� ✓ C) tJ L T E F� � � •`"'T'�1
� ' •USINLLi iARM SURVfy6
c�rr �oTS LANG SURVCYOR
' LAKESIfOME
� TO/OGRA►N�IC M�►�iNG REGISTERED UNGER LnY�S OF STATE OF MINN�ESOTA ' " JUDIC�AL
- � �ICENSEU�EY OND�NAhCES OF CITV pr MIhNCAPpL�S .
3300 �.YNDAL_E AVE 50 �•111VNEAPOLIS II. MINN. • .
' ' TAYLOR 4-U370 , . . �.. .
1
� - ����V�Y ��r J, M, CotJS�CRUCTiU�I C.�, �� .
.. `� �urbepor'� �eriific�fe • . � .� , � :
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: � v � � DGVEP� S�, .
�� `'aC�LE \�T =30' � ...:�S,Q•• --. -. _- '
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`�. hereby certify,that the above is a true and correct plat of a survey of:
'Y..;'� Lots 34, 35 and 36, F31ock W, Riverview fleights, Anoka County, Minneaota.
:, , .
�;��1�s surveyed by m� this 26th day of September 19G1 A. D.
% i% �I %�
rY � � r��� %
� � • cul 11CC1 •X�• 'f '! ,� � ' �
g , ._,. . .
; . , Minn�,�ota Registratian No . 2584
:`,•2 hereby certify that Z have resurveyed the above described property this
� '. � 20th day of I'ebruary 19G2 E�.D. , that the buildirig is entirely within �the
..`boundaries af said property as shown on the above plat and ti�ere are no
:
;visible encroachments of any nature unto or from adjoining properties.
; ,+I �,•�' : i ,c
. . !'. �,..:� � ' �.: �i.Y+� .
� �� . . ' ' 51�71CC� -�'r>, ''�� j;'�r�..' ..?.f'.? :C..i �.� , •
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• --- -- ------- -- -- - . �_,T_.., , , .
. _ \
AP.pLICATION FOR RESIDENTIAL, ALTERATION,
OR AllDITION.BUILDING PERMIT
C�ITY OF FRIDLEY, MINNESOTA
OWNER' S NAME : /,/✓I �._�� �7,�� � ��� _iBUILDER : /�z��� � �, �-v�--
A�DR�SS : Co.�4 ����cJ .�-�- /% � , ADDRESS : i�7J ��'�-r,d � %��-�-�—
/� �
NO : . � -�-G STRr ET • --t,-�--�� 6�-�- �� �-
LOT : �� 3 SI � �, BLOCK: LC> ADDITION :�-2- tr.` .r.�� B � , ...- ��-�".a _
CORI�TER LOT: INSIDE LOT: � SETBACK: SIDEYARD:
Applicar.t attach to this form Two Certificate: of Survey of L�t and proposed •
building locaCion drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As: .
GC��k.�c�l� Front : / � Depth : � �_Height : � �
�
��� Square Feet: � 3 L Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
2`ype of Constructio:�:�._.��.-`� Estimated Cost: $����
To Be Completed: ��� � � � ' � G
The undersigned hereby makes applicatinn for a pei-mit for the work herein
specified, agreeing to do all work in stTict accordance with the City of
Fridley Ordinances and rulings o= the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
��r-�-��F /`�---`-�-`' C°' .
� ,,/ � �
DATE : 5 � - nZ l� `- �J S IGNATURE • � �kx c�,�� � Z� �z..�'
(S�e Reverse Side For Additiona� Information.)
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560-345Q
�`t o i`dte
r� �
ANOKA COUNTY
6431 UNI`JERSIiY AVENUE NE FRIDLEY, MWNESOi'A 55432
July 1Q, 1975
Mr. Ardath Fuehrer
620 Dover Street N.E.
Fridley, Minnesota 55432
Re: Hard Surfaced Driveway
Dear Mr. Fuehrer:
On July 9, 1975, we inspected your new attached garage for
completion. We noted that the driveway had not been hard-
surfaced yet, and we want to call to your attention that
this was a stipulation on your garage permit dated May 28,.
1975.
You do have one year or until June 1, 1976 to complete this
and your cooperation in getting it completed will be appre-
ciated.
If you have any questions with reference to this matter,
please call me at 571-3450.
Yours very truly,
�.�1, ,
DAFtREL CLAi2K
Community Dev2lapment Administrator
& Building Official
DC/cs
sue�ecr PER
City of Fridley . 14110
A7 THE TOP OF 7HE TWINS g U I L D I N G P E R M I T
r
� � RECEIPT NO.
� ; L __���_ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
i ,
i
�l /'�'1 � CITY HALL FRIDLEY 55432 NUMBER REV. OATE PAGE OF APPROVEO BY
`.���� � �.J
612-560-3450 91O-F15 S�2'��7'� / �
JOB ADDRESS 620 Dover Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oesca. 34-36 W Riverview Heiqhts SHEET
2 PROPEFTY OWNER MAIL ADDRESS 21P PHONE
Ardath Fuehrer 620 Dover Street N.E.
3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO.
Mel W. Larson Co. 2716 Kentucky South, Mpls. 929-0053
4 ARCHITECTORDESIGNEf; MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE N0.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ApDITION ❑ ALTERATION � REPAIR ❑ MOVE O REMOVE
8 DESCRBE WORK
Reroof House
9 CHANGE QF USE FROM TO
STIPULATIONS
Original roof to be removed
SE��RATE P��t�l �S REf�t�t�E�. F.�R 1PVIktt�i�,
�JITiNC� PLt11i�BING aP�� S1CNS.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REDUIREO FOR ELECTRICAL, PIUMBING, HEATING,
VENTILATING OR AIF CONDITIONING. ASp�'I.dI't
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S�. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTEF WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ]. STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THtS TYPE OF WORK WILL BE COMPLIED �`�,� SOO y�. %S
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �`9.00
S7qUCTION OR THE PERFORMANCE OF CONSTRUCTiON. �
�[ I jf �j PLAN CHECK FEE TOTAL FEE
J`� ��; � "�7� ! $9.75
SIGNATUREOFCONiFACTORORAU7HORIZEDAGENT (DATEI WHEN P PERLY VA DATED THIS !S YOUR PERMIT
� I� ���-��
SiGNATURE OF OWNERIIF OWNER BUILDERI IDATEI Y BLDG iNSP � DAT�
CITY OF FRIDLEY
APPLICATION FOR R�SII)��JTiAL BUILDING PERt�IITS
iNEW, ALTERATIONS, ADDITIONS, OR iEPAIRS)
047P1ER: � /eQf � I �"1 �U � !T %��%Z BUILDER: ,/'�� � �i(,� � � y� �2 S O�I �
Address : �p � — �% � �/�� s %"� Address : � 7< 6 ^ ��f2 �l� �`� C � � � �
,,�---- �
Tel . No . � 2._� —� B S��
No. :�d`-C% Street: / / � �%�12. � 7`
LOT: �"'� BLOCK: � ADDITION: � � �/ ��, t���,�' (� ��� ��C�
CORNER LOT: INSIDE LOT: Si.TBACK: SIDEYARDS:
A�plicant attach to this fo r,n Two Certificates of Survey of Lot and proposed
building locai.ion drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
�JlG �00� � Front: , Depth: Height:
q�Q(,lS� Square Feet.: � Cubic Feet:
�•
Fron t :
Square Feet:
Depth:
Cubic Feet:
Height:
Type of Construction: ��,�j�,L�L ��' Estimated Cost: $ l J�D��
To Be Completed: � --- � — � �
AIt. A Alt. B
Proposed Driveway Wic3th If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct. See reverse side far additional information. �
DATE: jj�— � �" '! � SIGNATURE: �./��?%C.r'�OL/� -
Stipulations:
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M r+ �
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sue�etr PERMI
c;ty of Fr�a�ey 3� 6-2�2.
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
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� � RE O.
� � COMMUNITV DEVELOPMENT DIV. �, /
� •
' �V �����" .
r � � PR07ECTIVE INSPECTION SEC. ��
� � �"'1 � CITV NAIL FRIOIE� 55�32 NuMBEa pEV O�TE P�GE OF •CVROvEO Br
�""�'� �'' 612-571--3450 9�0-Ft5 l/19/O1 / /
JOB ADpRESS 620 Dover Street NE
t IEGAL �OT NO. BLOCK TRACT OR AODITION SEE ATTACHED
oesca. 34,35,36 W Riverview Heights SHEET
2 PFOPERTY OWNEii MAIL ADORESS ZIP PMONE
David Rossi 620 Dover Street NE 763-785-1168
3 CONTRACTOR MAIL ADORESS Z�P PHONE IICENSE NO
Same
e ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO
5 ENGINEER MAIL AODRESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CIASS OF WORK
O NEW O ADDITION C� ALTERATION ❑ REPAIR p MOVE O REMOVE
8 DESCRIBE WORK
Basement wall framing, sheetrock
9 CHANGEOFUSEFROM TO
STIPULATIONS
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV �OAO
SEPAqATE PERMITS ARE REOU�FiEO FOR EIECTRICAL, PLUMBING, NEATING.
VENTILATING OR Alii CONDITIONING
TMIS PERMIT BECOMES NULL AND VOID If WORK OR CONSTRUCTION ZpNING SO. FT CU fT
AUTHORIZED IS NOT COMMENCED Vy1THIN 60 OAYS. OR IF CONSTRUCTION
OA WORK IS SUSPENDED OR ABANDONEO fOR A PERI00 Of 120 OAVS AT
ANV TIME AFTER WOqK IS COMMENCED NO OWLG. UNITS OfFSTREET PARKING
1 MEREBY CERTIFV THAT I HAVE REAO ANO EXAMINED THIS APPLICATtON 1 STA��$ GARAGES
AND KNOW TNE SAME TO BE TRUE AND CORRECT ALl PFOVISIONS Of LAWS VA�UATION SURTAX
AND ORDINANCES GOVERNING THIS TVPE OF WORK WI�� BE COMP�IEO
WITM WMETMEF SPECIFIED MEREIN OR NOT. THE GRANTING OF A PERMIT SOO �.SO
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pEqMITfEE SACCHARGE
pROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGUTATING CON-
STRUCTION Of7 THE PERfORMANCE Of CONSTRUCTION �23.50 Fire SC �.SO
PLAN CNECN fEE OTA� FEE
$24.50
5 NATUQEOFCONCFACTOQOpOUTHOQ�ZEO4GENT iD�TE� M PRO LY VAU TED THIS IS V UR PERMIT
J\ �i 1.;�1�� ��� tl� r y D
S�GaaiuAE O� OwaEQ��� OWNEQ BwIDEQ� �D�TE� � •. B G�ti5� � ����E
NEW [ ] Effective 1/1/2001
ADDN [] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: � ab � � eh- ��' NF
Legal Description:
Owner Name & Address: �u; d Po ss �� Tel. #� �3 - 7�S- J/G 8
Contractor: se I� MN LICENSE #
Address: (�a� Liaacn s} NC Tel. # 5'�''"'�'
LIVING AREA:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA:
OTHER:
Length Wdth Hgt/Ground Sq. Ft.
�.
B a sc Ma„ �- u.lx i( �l� w+ •�.e, ��? o c�C
Construction Type: Estimated Cost: $ 'S6o. o�
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: �') cl-C) � APPLICANT: �ttu �(� i1 �esSr Tel. # 7l03-'% �S- //G $
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailing in application
$�,3. �l� Fee Schedule on Reverse Side
$ - Sl� .001 of PermitValuation (1/10th%)
$ . SU $.50/$1,000 Valuation
$ $1150 per SAC Unit
$ $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
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